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Home My WebLink About20241747.tiffRESOLUTION RE: APPROVE AGREEMENT FOR SUBSTANCE ABUSE TREATMENT SERVICES AND AUTHORIZE CHAIR AND DEPARTMENT OF HUMAN SERVICES TO SIGN - SIGNAL BEHAVIORAL HEALTH NETWORK WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with an Agreement for Substance Abuse Treatment Services between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and Signal Behavioral Health Network, commencing June 1, 2024, and ending June 30, 2025, with further terms and conditions being as stated in said agreement, and WHEREAS, after review, the Board deems it advisable to approve said agreement, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Agreement for Substance Abuse Treatment Services between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and Signal Behavioral Health Network, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair and Jamie Ulrich, Director of the Department of Human Services, be, and hereby are, authorized to sign said agreement. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 26th day of June, A.D., 2024, nunc pro tunc June 1, 2024. BOARD OF COUNTY COMMISSIONERS WELD COUNTY_,,,QQ1.QB�DO ATTEST: Weld County Clerk to the Board BY: • it.JOAuYid-- APP Deputy Clerk to the Board RM: County A orney ril ► 124 ` ' (�"�c Date of signature: �'`,., IS La Kevi D. Ross, Chair erry L. Bu , Pro-Tem Mike Freeman 1/42 t K. James i Saine cc:I-tSO of/I5/2.N 2024-1747 HR0096 Con-rvac+ X 860 , BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Substance Abuse Evaluation and Treatment Agreement with Signal Behavioral Health Network DEPARTMENT: Human Services DATE: June 11, 2024 PERSON REQUESTING: Jamie Ulrich, Director, Human Services Brief description of the problem/issue: The Department is requesting to enter into an agreement for FY 2024- 25 with Signal Behavioral Health Network for Substance Abuse Evaluation and Treatment. The new Agreement updates rates and the term dates for the new fiscal year. Due to varying State funding cycles, the periods of performance within this agreement will overlap. For Core Services funding, the period of performance shall be June 1, 2024, through May 31, 2025, unless sooner terminated. For Additional Family Services (AFS) funding, the period of performance shall be July 1, 2024, through June 30, 2025, unless sooner terminated. The Department agrees to contract with Signal for a maximum of $272,180.25 in Core Services funding. Signal agrees to contribute a maximum of $177,819.75 in AFS funds, as designated by the Office of Behavioral Health (OBH), for the purpose of serving eligible clients in accordance with the terms of this agreement. The updated rate table is attached for your reference. What options exist for the Board? • Approval of the Substance Abuse Evaluation and Treatment Agreement with Signal Behavioral Health Network • Deny approval of the Substance Abuse Evaluation and Treatment Agreement with Signal Behavioral Health Network Consequences: The agreement for Substance Abuse Evaluation and Treatment will not be executed. Impacts: Weld County clients will not have the option to use these services. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): • Total cost = $272,180.25. • Funded through Child Welfare Core Program and Additional Family Services (AFS) funding. Pass -Around Memorandum; June 11, 2024 - CMS ID 8303 2024-1747 Lon lo H12009 Co Recommendation: • Approval of the Substance Abuse Evaluation and Treatment Agreement and authorize the Chair to sign. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro-Tem Mike Freeman Scott K. James Kevin D. Ross, Chair Lori Saine (1' Pass -Around Memorandum; June 11, 2024 - CMS ID 8303 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS This Agreement is between the Weld County Department of Human Services, hereinafter referred to as "WCDHS" and Signal Behavioral Health Network, and hereinafter referred to as "Signal. WHEREAS, the Colorado Department of Human Services has provided Colorado Core Services substance abuse treatment funding to WCDHS for outpatient and residential core services for families, children, and adolescents; and WHEREAS, WCDHS requires the services of substance abuse treatment providers to assist the County in delivering substance abuse treatment services to child welfare clients, and Signal is willing and able to coordinate and manage such services; and WHEREAS, Signal is a Colorado not -for-profit corporation organized for the purpose of managing and coordinating high quality, cost efficient, integrated chemical dependency and related behavioral health care services in the State of Colorado. NOW, THEREFORE, it is mutually agreed as follows: I. INTRODUCTION. The terms of this Agreement are contained in the terms recited in this document and in Exhibits A, B, C, D, and E, each of which forms an integral part of this Agreement. Exhibits A, B, C, D, and E are specifically incorporated herein by this reference. WCDHS and Signal acknowledge and agree that this Agreement, including specifically Exhibits A, B, C, D, and E define the performance obligations of WCDHS and Signal and the parties' willingness and ability to meet those requirements. II. SERVICES: A. Responsibilities of Signal 1. Signal agrees and desires to participate as the service provider coordinator for WCDHS qualified child welfare clients. This service is described in State CDHS Rules and Regulations Volume 7, Section 7, and the State approved Weld County Family Preservation Program/Core Service Plan. Section 7.303.1 of Volume 7 describes Core Substance Abuse Treatment Services as: diagnostic and/or therapeutic services to assist in the development of the family service plan, to assess and/or improve family communication, functioning and relationships, and to prevent further abuse of drugs or alcohol. 2. Signal will ensure the delivery of a high quality of clinical care to clients in a delivery system of limited resources and public funding. The full continuum of care (Outpatient, Intensive Outpatient, Transitional Residential, Intensive Residential, Therapeutic Community, or comparable alternatives as mutually Page 1 of 36 ,z002/-/7�7 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS agreed upon) will be available to clients. The client's clinical needs will determine the level of care Signal is to provide and Signal will meet those needs regardless of "modality." 3. Signal will assure that all eligible child welfare clients referred by WCDHS in need of treatment will receive such in accordance with American Society of Addiction Medicine Patient Placement Criteria (ASAM PPC) II R level of care, as reimbursed by the State of Colorado, Office of Behavioral Health. 4. It is the intention of WCDHS to utilize the substance abuse counselors/therapists furnished through Signal providers to provide substance abuse evaluation and treatment services for all of WCDHS qualified clients at agreed upon rates for specified services. Signal will ensure that provider therapists will provide all of the following services for Weld County clients: assessments, evaluations, standard out -patient services, enhanced out -patient services and intensive out -patient services. 5. Signal will evaluate priority service as follows: a. Signal will give priority service to child welfare clients (parents and children) who comply with the following criteria as WCDHS refers: i. Case is active on TRAILS, and ii. Case meets the State DHS program category criteria 4, 5, or 6, and, iii. Case meets the definition of "imminent risk for out -of -home placement/reunification" set forth by the State of Colorado. b. Signal will secondarily evaluate and treat ColoradoWorks, Temporary Assistance for Needy Families (TANF), and Employment First clients as referred by WCDHS. 6. Signal will include the following provisions in all subcontracts with providers: a. The Provider shall submit a treatment plan to WCDHS within thirty (30) days. b. The Provider shall enter monthly progress reports into the Signal system no later than the 7th calendar day of the month following the month during in which the service was rendered. Services submitted without monthly progress reports will be pended for official billing and utilization against AFS funds until such reports are submitted. Page 2 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS C. Providers will give timely notice of cancelled appointments to the clients and will reschedule such appointments as soon as practical. 7. Signal, or their designee, agrees to provide WCDHS monitoring results (UA, BA, patch, tox trap) by faxing said results to WCDHS at (970) 346-7667 or via access to online system no later than 72 hours after the day of service. 8. Signal agrees to make available Core and AFS Utilization Reports to WCDHS each month by the 7th of each month. 9. Signal agrees to cooperate with WCDHS to resolve any duplicated fees and/or errors identified by the WCDHS billing review process. 10. Signal will also make monthly progress reports available on its website for each WCDHS client in treatment by the 7th of the month following the date of service. 11. Signal will provide training and technical support, as necessary, for WCDHS staff in accessing data and billing reports and on the use of the child welfare referral system. 12. Signal shall reconcile all treatment providers' claims to AFS funds within 90 days from the date of service delivery. Claims not properly submitted to Signal within this timeline will be denied. 13. Signal will assure that the providers in its network give timely notice to cancelled appointments to the clients and will reschedule such appointments as soon as possible. 14. Signal will collaborate with WCDHS and the providers in its network to provide quarterly reports to WCDHS which contain timelines from referral date to service start date, service length of stay, service no show rates, service completion rates and average number of outreach contacts to clients to engage them in treatment. WCDHS will provide a template to the providers as requested. 15. At all times from the effective date of this Contract until completion of this Contract, Signal shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under the Child Welfare Services and Family and Children's Program funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 3 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS 16. Signal agrees to comply with the Standard Procedures for Core Services as set forth in the attached Exhibit E, which is attached hereto and incorporated herein by reference. B. Responsibilities of WCDHS: 1. WCDHS will work cooperatively with Signal and its Providers to deliver quality, efficient and cost-effective substance abuse treatment services to WCDHS qualified clients. 2. WCDHS will make every effort to inform Signal and its Providers in a timely manner of system issues, developments, and complications so that Signal and the Provider can make informed choices in its role as the managed service organization and treatment agency respectively. 3. WCDHS will assure that all referrals under this contract meet the eligibility criteria expressed in Section l(A)(5) above. 4. WCDHS agrees to provide Signal with the name of a primary contact person who will be responsible for interacting with Signal's accounting and information systems departments. 5. WCDHS, or its authorized designee(s), will be responsible for electronically authorizing services to various providers. 6. WCDHS will review monthly AFS actual reports and determine any duplicate charges pursuant to Core or other previously paid services. WCDHS will report monthly any discrepancies in duplication and/or errors to Signal, and in cooperation with Signal, work with Signal to resolve any conflicts of billed services or fees. 7. WCDHS will send a remittance advice within 10 business days of completion of each month's TRAILS payroll date. WCDHS shall work with Signal and other counties to develop standard claims denial criteria. WCDHS shall reimburse Signal for all complete services invoiced within 45 calendar days from the date of receipt of Signal's invoice. 8. WCDHS shall inform Signal of the county primary contacts along with contact information. WCDHS shall provide such contact information for all contract, data and billing related matters. Page 4 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS III. PERIOD OF PERFORMANCE Due to different State funding cycles, the period of performance under this Agreement will overlap. For the County Core Services the period of performance shall be for the 12 - month period beginning, June 1, 2024 through May 31, 2025, unless sooner terminated. The Signal Additional Family Service (AFS) period of performance under this Agreement shall be for the 12 -month period beginning July 1, 2024 through June 30, 2025, unless sooner terminated. Either party hereto may terminate this Agreement at any time by giving not less than 45 days advance written notice to the other party. As a condition of continuing to render services under this Agreement, it is understood that Signal will report any limitation or restriction of their license or insurance or the ability to perform the services covered by this Agreement under any condition of impairment. In the absence of any formal agreement beyond the term of this agreement, Signal agrees to continue providing treatment, under the terms of this agreement, for clients that are in treatment or referred by WCDHS for treatment. This is with the further understanding that service delivery and payment are subject to the termination terms mentioned above. Signal reserves the right to suspend services to clients if funding is no longer available. WCDHS acknowledges financial responsibility for all services authorized and performed before the effective date of termination. IV. COMPENSATION See Exhibit A for specific compensation which is attached hereto and incorporated by reference. V. CLIENT FEES OR CO -PAYS Neither Signal nor their network Providers shall assess a client fee or co -pay to child welfare clients served under this contract unless the client is required to pay for any positive urine screen as a condition of their Family Service Plan or through court order for monitored sobriety and/or treatment as a condition of their treatment plan. Any such client fees or co -pays shall be outside the scope of this contract, and Signal shall have no responsibility for accounting for such fees and co -pays. VI. INDEPENDENT CONTRACTOR Signal and its providers shall be providing services hereunder as an independent contractor and the relationship of employer and employee does not exist between WCDHS and Signal. None of the provisions of this Agreement are intended to create, nor Page 5 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS shall they be deemed or construed to create any relationship among Signal, Providers, or WCDHS other than that of independent entities contracting solely for the purpose of effecting the provisions of this Agreement. Signal and Providers shall pay when due all required employment taxes and income withholding taxes, shall provide and keep in force worker's compensation (and show proof of such insurance as requested) and unemployment compensation insurance in the amounts required by law, and shall be solely responsible for the acts for Signal, its employees and agents. VII. ASSURANCES Signal shall abide by all assurances as set forth in the attached Exhibit D, which is attached hereto and incorporated herein by reference. VIII. COMPLIANCE WITH APPLICABLE LAWS AND NON-DISCRIMINATION A. At all times during the performance of this contract, Signal shall strictly adhere to all applicable federal and state laws, orders, and all applicable standards, regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. Signal acknowledges that the following laws are included: Title VI and VII of the Civil Rights Act of 1964 and 1986 amendments, 42 U.S.C. Sections 2000d —1 et. sew.. and its implementing regulation, 45 C.F.R. Part 80 et. sep.: and Sections 503 and 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and the Age Discrimination in Employment Act of 1967; and the Equal Pay Act of 1963 as amended; and the Education Amendments of 1972; and Immigration Reform and Control Act of 1986, P.L. 99-603; 42 C.F.R. Part 2 Executive Order 11246, as amended Title VII and VIII of the Public Health Services Act Vietnam Era Veteran's Readjustment Assistance Act of 1974 Non-discrimination laws of the State of Colorado. B. All regulations applicable to above referenced laws prohibiting discrimination because of race, color, national origin, and sex, religion, veteran status and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Signal and WCDHS will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Page 6 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS C. WCDHS and Signal shall sign a Qualified Service Organization Agreement in compliance with 42 CFR Part 2, and attached hereto and incorporated by reference as Exhibit B. D. Additionally, 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. E. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services, Office for Civil Rights. IX. EMPLOYMENT OR CONTRACTING UNDER COLORADO LAW Except where exempted by federal law and except as provided in Section 24-76/5-103(3), C.R.S, if Signal receives federal or state funds under this Agreement, Signal must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to Section 24-76.5-103(4), C.R.S., if such individual applies for public benefits provided under this Agreement. If Signal operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall product one of the forms of identification required by Section 24-76/5-101. et seq., C.R.S., and (c) shall produce one of the forms of identification required by Section 24- 76.5-103, C.R.S., prior to the effective date of this Agreement. X. CERTIFICATIONS Signal certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc. required to properly provide the services and/or supplies covered by this contract. XI. MONITORING AND EVALUATION Signal and WCDHS agree that monitoring and evaluation of the performance of this Agreement shall be conducted by Signal and WCDHS. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and Signal. Signal shall permit WCDHS, and any other duly authorized agent or governmental agency, to monitor all activities conducted by Signal pursuant to the terms of this Agreement. As Page 7 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS the monitoring agency may in its sole discretion deem necessary or appropriate, such program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. XII. ACCESS TO RECORDS Signal, its Providers and WCDHS agree to make available in a timely manner, all books, documents, and records pertinent to this contract for the purpose of billing for services, audit, and compliance with requirements and regulations of federal and state agencies and commercial insurance carriers. Signal acknowledges that in reviewing, storing, processing, or otherwise dealing with any client records dealing with any client seen by a Signal provider or the on -site substance abuse counselor is bound by the confidentiality provisions of 42 CFR Part 2. If necessary, Signal shall resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. XIII. MODIFICATION OF AGREEMENT All modifications to this agreement shall be in writing and signed by both parties. XIV. REMEDIES A. Signal and WCDHS shall exhaust all remedies as provided in Exhibit E, "Standards of Procedures for Core Services", if applicable, prior to pursuing any further remedies provided in this section of the Agreement. B. The Director of WCDHS or designee may exercise the following remedial actions should s/he find Signal substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by Signal that is not corrected through procedures set forth in Exhibit E. These remedial actions are as follows: Provide reasonable advance written notice of perceived failure to satisfy the scope of work. After Signal receives such notice and a reasonable opportunity to cure WCDHS may withhold payment of Signal until the necessary services or corrections in performance are satisfactorily completed; and ii. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by Page 8 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS Signal cannot be performed or if performed would be of no value to the WCDHS. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to WCDHS; and iii. Incorrect payment to Signal due to omission, error, fraud, and/or defalcation shall be recovered from Signal by deduction from subsequent payments under this Agreement or other agreements between WCDHS and Signal, or by WCDHS as a debt due to WCDHS or otherwise as provided by law. C. Signal may appeal the decision of the Director of WCDHS or designee, as provided in this Section, by submitting, within thirty (30) calendar days of the Director's action, and basis of such appeal to the Board of County Commissioners. D. Should disputes remain, Signal and WCDHS hereby agree to submit all unresolved controversies, claims, and disputes arising out of this Agreement to mediation in Denver, Colorado, according to the commercial rules and practices of the American Arbitration Association then in force, or pursuant to other rules or procedures as to which the parties may agree. Mediation is not binding and regardless of the outcome, each party agrees to fund their own litigation expenses. XV. OBLIGATIONS Obligations of WCDHS and Signal are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. XVI. PROVISIONS This Agreement may be amended only by written agreement signed by each of the parties hereto. This Agreement shall be binding upon and shall inure to the benefit of the respective parties hereto and shall not be assigned without the consent of all parties hereto. XVII. NOTICES: Any notice required to be given pursuant to the terms and provisions hereof shall be in writing and shall be sent by certified mail, return receipt requested. To Signal at: Daniel Darting CEO Signal Behavioral Health Network Page 9 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS 6130 Greenwood Plaza Blvd., Suite 150 Greenwood Village, CO 80111 To WCDHS at: Jamie Ulrich Director Weld County Department of Human Services P.O. Box A Greeley, CO 80632 XVIII. LITIGATION Signal shall promptly notify WCDHS in the event that Signal learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Signal, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the WCDHS Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganization and/or foreclosure. XIX. MISCELLANEOUS PROVISIONS A. Headings. The headings of the sections and subsections of this Agreement are inserted solely for ease of reference and shall not in any way affect the meaning or interpretation of this Agreement. B. Non -Assignment. None of the parties shall have the right to assign the benefits or delegate the obligations in this Agreement without prior written consent of the other parties. Subject to the foregoing, this Agreement shall be binding upon and inure to the benefit of the parties and their respective heirs, successors, legal or personal representatives and permitted assigns. C. Waiver of Breach. The waiver of any party of a breach or violation of any provision of this Agreement shall not operate as, or be construed to be, a waiver of any subsequent breach of the same or any other provision thereof. D. Gender and Number. Whenever the context of this Agreement requires, the gender of all words shall include the masculine, feminine and neuter, and the number of all words shall include singular and plural. E. Severability. If any provision of this Agreement is held to be unenforceable for any reason, the unenforceability thereof shall not affect the remainder of this Agreement, which shall remain in full force and effect and be enforceable in Page 10 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS accordance with its terms. F. Counterparts. This Agreement may be executed in duplicate originals, each of which shall be an original instrument but both of which taken together shall constitute one and the same instrument. G. Entire Agreement. This Agreement constitutes the entire understanding and agreement between the parties with respect to its subject matter and supersedes all prior agreements or understandings, whether written or unwritten, with respect to the same subject matter. H. Non -Exclusivity. Participation in this Agreement shall be non-exclusive in nature and either party may enter into other Agreements other than through Signal or WCDHS. The only restriction is on the amount of funding included in this Agreement. Neither party may enter into other Agreements that may dilute the funding base in this Agreement. Hold Harmless. To the extent authorized by law each party agrees to defend, hold harmless, and indemnify the other party and its affiliates, directors, trustees, officers, and employees from and against all claims, demands, suits, judgments, expenses, and costs of any and all kinds arising as a result of damages or injuries arising out of, or incident to, the performance or failure of performance of this Agreement by such indemnifying party or its agents of its duties, obligations, or rights hereunder. J. Negligence/Malpractice. In the event that negligence or malpractice of Signal or an employee of Signal shall subject County to potential or actual liability, Signal shall hold the WCDHS harmless from all monetary loss resulting from such liability. This obligation to hold harmless shall, in addition to any other obligations commonly associated with it, would obligate Signal to pay all reasonable attorney fees, costs, expenses, and damages incurred as a result of such liability. Signal acknowledges that the WCDHS is a department of Weld County and, thus, to the extent authorized by law, Signal agrees to indemnify, save, and hold harmless the Board of County Commissioners of Weld County, or Weld County, or both, against any and all claims, damages, liability, and the like as above set forth. The indemnities and assumptions of liabilities and obligations herein provided for shall continue in full force and effect notwithstanding the expiration or termination of this Agreement. K. Third Party Beneficiary Enforcement. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of actions relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the Page 11 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. L Choice of Law/Jurisdiction. Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the Parties, Signal agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. M. Governmental Immunity. No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. APPROVED BY: Jun 3, 2024 Daniel Darting, Chief Executive Officer Date SIGNAL BEHAVIORAL - ETWORK 6J Kevin D. Ross, Chair WELD COUNTY BOARD OF COUNTY COMMISSIONERS Jami Ulrit (.1 2411,03 MDT) JUN 2 6 2024 Date Jun 4, 2024 Jamie Ulrich, Director Date WELD COUNTY DEPARTMENT OF HUMAN SERVICES Page 12 of 36 aoa- (7¢' SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS EXHIBIT A - COMPENSATION Compensation WCDHS agrees to contract with Signal for a maximum of $272,180.25 from their Core Service Funding. Signal agrees to contribute a maximum of $177,819.75 annually from designated OBH Additional Family Service (AFS) funds to serve eligible clients in accordance with the terms herein. Signal's administration fee shall be calculated as five percent of the service fees, salaries, and other authorized costs that are actually incurred in the delivery of treatment services. Signal's administration fee shall obligate Signal to perform, or deliver, the responsibilities, services, and reports specifically mentioned in this agreement. Other requested services or reports may be considered outside the scope of this agreement and, therefore, subject to an additional fee. Core Service funds may be used to pay for counselor services and will be dedicated to pay for drug tests and other authorized services. AFS funds will be used to pay for a .5 FTE co -located and dedicated WCDHS Substance Abuse and Mental Health (SAMH) Therapist who will be provided by North Range Behavioral Health (NRBH). This position will work with WCDHS clients and co -locate at WCDHS, NRBH and in the community. AFS funds may be used to pay for counselor services and will be dedicated to paying for withdrawal management, outpatient, residential treatment (TRT or IRT) at AFS funded providers in the Signal network and/or for other authorized treatment services. Medicaid will be billed first when available to pay for the services. Signal will utilize Core and/or AFS monies to pay for services in cooperation with the Core Services Coordinator. The WCDHS Core Services Coordinator will initially place all clients under either Core or AFS funding source for off -site services. Any changes that switch clients to another funding source will be mutually decided by the Core Services Coordinator and Signal prior to switching the funding source. If the parties fail to agree, the procedures contained in Exhibit E, shall be followed. All services for clients that have been designated as approved for services as of 6/1/2024 for Core, or 7/1/2024 for AFS, will be billed to either funding source according to the designation in effect on 6/1/2024. WCDHS will share a list of these clients and compare with a list that Signal produces to make sure that the lists from both entities are in agreement. Page 13 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS Payment A. Responsibilities 1. Signal shall submit an itemized monthly bill to WCDHS for all costs incurred and services provided in accordance with criteria established by WCDHS and Signal. Requests to modify criteria must be provided with 30 days advance notice. Signal shall submit all itemized monthly billings to WCDHS no later than the 7th of the month following the current month the cost was incurred in accordance with the Trails payroll calendar. Monthly billings received after 60 days from the date of services my result in delay or forfeiture of payment. 2. Signal shall make available, on its web site, monthly billing reports in accordance with the billing criteria established by WCDHS no later than the 7th of the month following the month of service. Monthly client progress reports must be made available to the Mental Health and Support Services Team, in the format provided by the Department, for download from the Signal database by the 7th of the month following the date of service. Signal's contracted providers will be required by Signal to input the monthly progress information into the Signal database prior to their ability to bill service charges for that client. Any incomplete progress report will be deemed incomplete, and all such associated services will be pended. 3. Failure to submit monthly billings and/or monthly client reports in accordance with the terms of this agreement or to comply with the Financial Management Requirements, program objective or other contractual terms or program objectives may result in Signal's forfeiture of all rights to be reimbursed for such expenses. In the event of a forfeiture of reimbursement, Signal may appeal such circumstance in accordance with the Remedies Section of this Agreement. 4. WCDHS shall not be billed for, and reimbursement shall not be made for, time involved in activities outside of those defined in Exhibit C, "Scope of Services" and this Exhibit's Fee for Reimbursement Schedule. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 5. Signal shall provide proper monthly invoices, make available monthly progress reports for each client incurring charges, and verification of services performed for costs incurred in the performance of the agreement. Page 14 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS AFS and Core Services Reimbursement Funding Sources AFS Core Total WCDHS dedicated provider salary and benefits $ 27,000.00 -- $27,000.00 Supplies, Supervision and Travel $2,440.00 -- $2,440.00 Subtotal-Onsite Costs $29,440.00 -- $29,440.00 Provider In -direct costs $4,710.00 -- $4,710.00 Signal administrative fee (5%) $1,707,50 -- $1,707.50 Total Onsite Costs $35,857.50 -- $35,857.50 Fee -for -service funding $135,202.14 $259,219.29 $394,421.00 Signal Fee $6,760.11 $12,960.96 $21,429.00 Total fee -for -service $141,962.25 $272,180.25 $415,850.00 Total Contract Costs $177,819.75 $272,180.25 $450,000.00 Fee -For -Service Reimbursement County Core Services and Signal AFS funding will be responsible for purchasing services in accordance with the schedule below (to a maximum funding specified in the contract language). The County and Signal acknowledge that all UA services MUST be physically monitored/observed by an individual in order for payment to be considered. The County and Signal further acknowledge that any and all monitoring beyond standard urinalysis or breathalyzer tests must be approved by the County prior to administration. Page 15 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS Payer Account(s) Weld County AFS Service Code 82075 Service Description Alcohol (ethanol): Breath Unit Each Payor Rate $ 5.25 Weld County AFS T1006 Alcohol and /or substance use services, Family/Couple Counseling Hour $ 80.77 Weld County Core 11006 Alcohol and /or substance use services, Family/Couple Counseling Hour $ 80.77 Weld County AFS H0001 Alcohol and or Drug Assessment Episode $ 232.05 Weld County Core H0001 Alcohol and or Drug Assessment Episode $ 232.05 Weld County AFS H0048 Alcohol and or drug screening; collection of handling only, specimens other than blood Each $ 43.66 Weld County AFS H0003 Alcohol and or drug screening; lab analysis of specimens for Prescence of alcohol or drugs Each $ 15.75 Weld County AFS H0005 Alcohol and or drug services; group counseling by a clinician Hour $ 68.25 Weld County Core H0005 Alcohol and or drug services; group counseling by a clinician Hour $ 68.25 Weld County AFS H0015 Alcohol and or drug services; intensive services outpatient ASAM 2.1 Day $ 105.00 Weld County Core H0015 Alcohol and or drug services; intensive services outpatient ASAM 2.1 Day $ 105.00 Weld County AFS H2036:U1 ASAM Level 3.1. Clinically Managed low intensity residential services Day $ 157.50 Weld County Core H2036:U1 ASAM Level 3.1 Clinically Managed low intensity residential services Day $ 157.50 Weld County AFS H2036:U1:HD ASAM Level 3.1 Special Connections Clinically Managed low intensity residential services Day $ 178.50 Weld County Core H2036:U1:HD ASAM Level 3.1 Special Connections Clinically Managed low intensity residential services Day $ 178.50 Weld County AFS H2036:U5 ASAM Level 3.5 Clinically Managed high intensity residential services Day $ 262.50 Weld County Core H2036:U5 ASAM Level 3.5 Clinically Managed high intensity residential services Day $ 262.50 Weld County AFS H2036:U5:HD ASAM Level 3.5 Special Connections Clinically Managed high intensity residential services Day $ 283.50 Weld County Core H2036:U5:HD ASAM Level 3.5 Special Connections Clinically Managed high intensity residential services Day $ 283.50 Weld County AFS H2036:U7 ASAM Level 3.7 Medically Managed high intensity residential services Day $ 472.50 Weld County Core H2036:U7 ASAM Level 3.7 Medically Managed high intensity residential services Day $ 472.50 Weld County AFS H2036:U7:HD ASAM Level 3.7 Special Connections Medically Managed high intensity residential services Day $ 493.50 Page 16 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS Payer Account(s) Weld County Core Service Code H2036:U7:HD Service Description ASAM Level 3.7 Special Connections Medically Managed high intensity residential services Unit Day Payor Rate $ 493.50 Weld County AFS H0004 Behavioral Health Counseling and Therapy, per 15 minutes Unit $ 26.25 Weld County Core H0004 Behavioral Health Counseling and Therapy, per 15 minutes Unit $ 26.25 Weld County AFS H2012 Behavioral health day treatment Hour $ 68.25 Weld County Core H2012 Behavioral health day treatment Hour $ 68.25 Weld County AFS J0571 Buprenorphine/naloxone (oral) all Month $ 472.77 Weld County Core J0571 Buprenorphine/naloxone (oral) all Month $ 472.77 Weld County AFS H0006 Case Management Alcohol and/or drug services; case management, per 15 minutes Unit $ 39.30 Weld County Core H0006 Case Management Alcohol and/or drug services; case management, per 15 minutes Unit $ 39.30 Weld County AFS H0010 Clinically Managed residential withdrawal management: ASAM 3.2 WM Day $ 210.00 Weld County Core H0010 Clinically Managed residential withdrawal management: ASAM 3.2 WM Day $ 210.00 Weld County AFS 80305 Drug Screen, presumptive, Optical Observation Each $ 5.25 Weld County AFS 80306 Drug Screen, presumptive, read by instrument Each $ 5.25 Weld County AFS 99215 Established Patient Office or Other Outpatient Visit with High MDM, typically 40 - 54 minutes Episode $ 204.75 Weld County Core 99215 Established Patient Office or Other Outpatient Visit with High MOM, typically 40 - 54 minutes Episode $ 204.75 Weld County AFS H3000 In -Home Addictions Treatment Day $ 105.00 Weld County Core H3000 In -Home Addictions Treatment Day $ 105.00 Weld County AFS S9480 Intensive Outpatient Program Day $ 367.50 Weld County Core S9480 Intensive Outpatient Program Day $ 367.50 Weld County AFS H0011 Medically Monitored inpatient withdrawal management: ASAM 3.7 WM Day $ 866.25 Weld County Core H0011 Medically Monitored inpatient withdrawal management: ASAM 3.7 WM Day $ 866.25 Weld County AFS H0020 Methadone Month $ 472.77 Weld County Core H0020 Methadone Month $ 472.77 Weld County AFS 90849 Multi Family Group Psychotherapy Episode $ 63.00 Page 17 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS Payer Account(s) Weld County Core Service Code 90849 Service Description Multi Family Group Psychotherapy Unit Episode Payor Rate $ 63.00 Weld County AFS H2033 Multi System Therapy for juveniles, per 15 minutes Unit $ 64.05 Weld County Core H2033 Multi System Therapy for juveniles, per 15 minutes Unit $ 64.05 Weld County AFS 12315 Naltrexone (Injection) Month $1,258.00 Weld County Core J2315 Naltrexone (Injection) Month $1,258.00 Weld County AFS 99203 New Patient Office or Other Outpatient with Low MDM, typically 30-44 minutes Episode $ 141.75 Weld County Core 99203 New Patient Office or Other Outpatient with Low MDM, typically 30-44 minutes Episode $ 141.75 Weld County AFS RLC:02 Recovery Living Community One Time costs Each $ 105.00 Weld County AFS RLC Recovery Living Community Scholarship Day $ 36.75 Weld County AFS H2036:ADOL Residential Adolescent Additional Rate Day $ 105.00 Weld County Core H2036:ADOL Residential Adolescent Additional Rate Day $ 105.00 Weld County AFS S9976 Residential Room and Board Day $ 99.75 Weld County AFS H0038 Self-Help/Peer Services, per 15 minutes Unit $ 33.60 Weld County Core H0038 Self-Help/Peer Services, per 15 minutes Unit $ 33.60 Weld County AFS T1017 Targeted Case Management, per 15 minutes Unit $ 15.75 Weld County Core T1017 Targeted Case Management, per 15 minutes Unit $ 15.75 Signal, in accordance with Federal HIPAA regulations, adopted a standard transaction code set for all treatment services on October 16, 2003, which are subject to change throughout each contract year. Even though this compliance changed the service labels and groupings (shown above), the net amount of the fees associated with those services has not changed. Page 18 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS EXHIBIT B SIGNAL BEHAVIORAL HEALTH NETWORK QUALIFIED SERVICE ORGANIZATION AGREEMENT Signal Behavioral Health Network (MSO) and Weld County Department of Human Services (WCDHS) hereby enter into a Qualified Service Organization Agreement (QSOA) whereby the MSO agrees to accept and serve WCDHS clients' substance abuse treatment needs. In light of the relationship between WCDHS and the MSO, WCDHS requires client identifying information and data and information related to the services furnished to the clients. WCDHS and MSO will have this relationship from June 1, 2024 - July 30, 2025, thus the QSOA will be in effect during this period. Furthermore, WCDHS: 1. acknowledges that in receiving, storing, processing, or otherwise dealing with any information from the MSO about the clients in the MSO's program, it is fully bound by the provisions of the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2; and 2. undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to clients otherwise than as expressly provided for in the federal confidentiality regulations, 42 CFR Part 2. -I T# Executed this QUO day of Daniel Darting Chief Executive Officer Signal Behavioral Health Network Page 19 of 36 2024. Jam9CIrth 202411,03 MDT) Jamie Ulrich, Director Weld County Department of Human Services ao,4-i74/7 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS EXHIBIT C - SCOPE OF SERVICES A. IN -HOME ADDICTION TREATMENT PROGRAM Turning Point Substance Abuse Treatment Scope of Services for State Fiscal Year 2024- 2025 The In -Home Addictions Treatment Program (IHAT) is an intensive in -home therapy program designed to serve at -risk families that have come to the attention of the Department due to drug/alcohol concerns. Clients referred to the IHAT program typically have a mental health and/or substance abuse disorder and are continuing to struggle despite having been treated at lower levels of care such as outpatient therapy. Families served in the program often have a history that may include inpatient substance abuse treatment, trauma, criminal and/or delinquent behaviors, verbal or physical aggression, or attachment difficulties. Features of the program include: Intensive short-term treatment, averaging 4 to 5 months in duration. Two sessions per week in -home (or 1 session and phone consultation, dependent on client need). Availability of on —call services 24 hours a day 7 days a week. Case consultation with collaterals such as treatment providers (SA and MH), school personnel, probation, DHS, etc. Therapist flexibility in terms of drawing from a variety of evidence -informed treatment models including Seeking Safety, Dialectical Behavioral Therapy, Trauma Informed Cognitive Behavioral Therapy, Cognitive Behavioral Therapy, Solution Focused Therapy, and behavior management techniques. Drug testing of clients as therapeutically necessary. Therapist flexibility in terms of modality of treatment used (parents -only sessions, family therapy, occasional individual therapy, or some of each). Focus of treatment that is highly parent/family oriented and interventions designed to be sustainable for the family. Support in linking to other therapeutic services as appropriate including coaching, medication evaluation and management, substance abuse treatment, DBT programming, trauma focused services, etc. Integrating social supports into family treatment planning. Establishing positive daily life routines. Develop family stable patterns: Rules, Roles, Rituals, Routines, Relationships (Barnes, 1995). Additional interventions for parents of delinquent adolescents around monitoring/supervision, holding youth accountable for behavior and choices, and therapists will collaborate closely with the juvenile justice system. Page 20 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS B. CO -LOCATED AND DEDICATED WCDHS SUBSTANCE ABUSE AND MENTAL HEALTH (SAMH) THERAPIST North Range Behavioral Health (NRBH) will provide a .5 FTE CAS Certified, Master's Level Substance Abuse and Mental Health (SAMH) Therapist to work with WCDHS clients. The SAMH Therapist will be co -located at WCDHS, NRBH and in the community. The SAMH Therapist will provide case consultation, integrated assessments, therapy and case management services for clients within the WCDHS Child Welfare Division, to include: Maintaining a caseload of 6-10 adults and juvenile clients to include service planning and follow up. Completing substance abuse evaluations on adults and juveniles using the ASAM assessment tool. Conducting short term safety plans for both adults and juveniles. Participate in the discharge and relapse prevention planning with the client, caseworker, and service team. Completing monthly data that will be provided to WCDHS and Signal. Attending agency specific meetings when requested meetings include (TDM's, FTM's, Group Supervision, etc.) Providing consultation and services to caseworkers, supervisors, and Weld County staff. Attending WCDHS staffing's with the caseworker and report on progress on the adult and/or juvenile. Page 21 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS Goals of service: Immediate access to casework staff for case consultation and/or meeting with clients. Same week access to integrated assessments. Same week referral to NRBH for other services. Problem -solving systems issues, including delayed appointments, lack of client engagement, miscommunication between caseworkers and clinical staff. Outcome of Services: • Reduced length of time from referral to intake and assessment. • Increased communication between caseworkers and clinical staff. • Thorough assessments to include recommendations necessary for parents to safely maintain children at home or to engage in treatment so that children can safely return home. C. ASSESSMENTS 1. Alcohol and Drug Differential Assessment (3 -Hours) Assessment will evaluate alcohol/drug involvement as well as mental health status, history of mental health issues, sexual history, legal history, and certain standard tests (ASAP, ASAM PPC-2, ASI, SOCRATE, AODUI, Drinking History Questionnaire, Family Environment Scale) may be given. Signal will provide two collateral contacts as part of the Assessment. 2. Co -Occurring Alcohol and Drug with Domestic Violence Assessment (3 -Hours) Summary of assessment with recommendations sent to referring agency. The following areas will be assessed: Criminal History Profile of Client's Violent Behaviors Potential for Violence Mental Health Status Client's Medical History Substance Abuse History Suicidal/Psychological/Cultural History Milton Test, if needed 3. Substance Abuse Forensic Evaluation (3 hours, as staff expertise permits) Page 22 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS A forensic evaluation is specifically geared toward the substance -abusing offender. It involves additional testing to determine the criminogenic aspect of the person to be taken into consideration when developing treatment recommendations. Testing will be comprised of CVI, ASUS, SASSI, Millon Clinical Multiaxial Inventory (MCMI- III), a clinical interview, and a behavioral profile. The testing is cross-referenced with the clinical interview, and in relation to collateral data. 4. Evaluation: II - Level II Assessment A Level II Assessment is the initial diagnostic interview enrolling a client in services. It is conducted by a Master's Level Therapist (OR AT THE MINIMUM A CAC II OR III). A Level II is typically completed in 1-1.5 hours. Areas addressed: Referral information and Chief Complaint / Precipitating Event(s) Presenting Problem Psychosocial History Legal History Abuse and/or Victimization History Strengths, Resources and Needs Prior Treatment History Drug and Alcohol History and Assessment Medical History Mental Status DSM Diagnosis and Rationale Risk Assessment Level of Care Assessment Disposition and Recommendations for treatment 5. Evaluation: Ill - Level Ill Assessment In addition to all areas identified in the Level II assessment, a Level III may include the use of assessment tools and/or include extensive history review and collateral input as appropriate. A Level III Assessment is always completed by a dually trained and credentialed (license and certification) Behavioral Health Therapist so that, if necessary, he or she can act as an expert witness. A Level III is typically completed over the course of 2-3 hours. All Co -Occurring Alcohol or Drug with Domestic Violence or Anger Management assessments will be billed at the Evaluation: Ill rate. The primary difference between a Level II and Level III assessment is the amount of time involved (2-3 hours for a Level III versus 1-2 hours for a Level II). A Level III assessment requires more time and is more in-depth than a Level II assessment. A Level III assessment also includes more lengthy Page 23 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS documentation, typically will involve more collateral contacts, and is suitable for court purposes. Both assessments assess substance abuse and mental health issues/concerns. However, we do not dictate which tools are used for each Level of assessment. As indicated in the contract, a Level III assessment is always conducted by a duly trained and certified/licensed individual who can act as an expert witness if necessary. Level III assessments are typically requested by outside agencies for the purposes of obtaining clear information on treatment recommendations and prognoses (e.g., likelihood of continued risky behaviors). Collateral information/contacts are required (not just typical) in order to better understand the reason for the referring parties request for an evaluation, and a more formal written report is provided (e.g., no abbreviations or jargon, more comprehensive psychosocial history) so the referral source better understands the issues, and treatment recommendations and prognoses (e.g., likelihood of continued risky behaviors) are more formally addressed, as they pertain to the reason for the referral. Formal psychological testing is not administered for a Level Ill assessment. D. TREATMENT OPTIONS 1. Co -Occurring Alcohol and Drug with Domestic Violence Group Therapy (average length of treatment, 24 to 36 weeks): Groups for both men and women are offered. The group addresses anger management, healthy relationships, male and female roles, and boundaries. As needed, a Millon Test may be given, a standardized psychological test which measures functioning level in 22 personality disorders and clinical syndromes for adults (8t" grade reading level: > 18; available in Spanish). 2. Family Therapy (average length of treatment, 8 to 16 sessions): Involves two or more family members and provides therapeutic intervention to improve family communications, functioning, and relationships. Length of participation is dependent on client goals and progress toward meeting goals. 3. Individual Counseling (average length of treatment, 6 to 12 sessions): Primary client is seen on an individual basis. Length of participation is dependent on client goals and progress toward goals. 4. Substance Abuse Therapy (average length of treatment, 12 to 20 sessions): A group to enhance positive coping skills by focusing on their lifestyle dealing with use and abuse of chemicals. 5. Adult Intensive Outpatient (average length of treatment, 4 to 12 weeks): An intensive outpatient group therapy track that offers groups every evening, Monday through Friday, with a family program component. This program will Page 24 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS include medical aspects of addiction and adult relapse education components focusing on understanding the relapse process as well as group process (focuses on individual issues relating to their abuse of alcohol). The program length and participation level will be individualized based on the presenting issues and other factors. 6. Women's Group (average length of treatment, 12-20 sessions): A gender -specific group addressing issues affecting women and their relationships, such as family violence, co-dependency, self-esteem, and stress management. 7. Motivational Enhancement Therapy and Cognitive Behavioral Therapy for Adolescent Cannabis Users (MET/CBT5 average length of treatment 5-8 weeks): The MET/CBT5 is a brief treatment approach for cannabis abusing adolescents. Treatment consists of two individual motivational enhancement therapy sessions (MET) Sessions, followed by participation in three group cognitive behavioral therapy (CBT) sessions. The assessment includes a psychosocial history and data from the Global Assessment of Individual Needs (GAIN), and a personalized feedback report. 8. Adolescent Intensive Outpatient (length of treatment - 3 to 12 weeks): This intensive outpatient track offers therapy and education groups utilizing the Matrix Model for Youth and Young adults' curriculum. Groups are offered Monday through Friday. This program also provides individual and family therapy as well as family group therapy. Topics addressed include the medical aspects of addiction and relapse -prevention education focusing on understanding the relapse process. The program length and participation level will be individualized based on the presenting issues and other factors. E. SPECIAL PROGRAM OPTION 1. Special Connections (through pregnancy and up to one year postpartum): A gender -specific program that focuses on healthy babies, appropriate childcare, prenatal care, birth control, developmental stages of the baby, parenting skills, relationship issues, and other issues as identified by the counselor. Services include group and individual therapy, case management and family health education. F. MISCELLANEOUS SERVICE OPTIONS 1. Extended Detoxify Stay: This is an option when case management goals require that the person be in a stable environment until they can be referred to the next level of care. Page 25 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS 2. Enhanced Services: Enhanced services, as approved services that are requested by WCDHS for specific cases, which fall outside of the definitions, listed above in the description of the DBH menu of services. Enhanced services may be services not described on the menu, services not included in the definition or due to lack of economy of scale, or rural location, or result in additional costs to Signal. In order for Signal to provide enhanced service, the cost would be outside of the approved rates. Any additional fees would be negotiated on a case -by -case basis. Signal can arrange for services outside of the approved definitions, but WCDHS will be charged an additional fee that would be negotiated on a case -by -case basis by the designated representative listed in the contract. G. MEASURABLE OUTCOMES AND OBJECTIVES Signal shall abide by WCDHS outcome indicators of Safety, Permanency and Child and Family Well -Being, which are provided under Adoption and Safe Families Act (ASFA), 1997; Colorado Child and Family Services Plan 2000 —2004; and ACF Reviews (Reference: Federal Register, Volume 65, Number 16: 45 CRF Parts 1355, 1356, and 1357), March 25, 2000. 1. Outcome Reports as Prescribed by Human Services 2. Outcome reports will be developed and provided as mutually agreed upon by the parties. 3. Client Objectives The WCDHS caseworker will identify a maximum of three child welfare objectives to be addressed within each client's treatment plan. Signal shall develop action steps to reach the identified child welfare objectives. Signal shall report monthly on each client's progress in meeting the three identified objectives while the client is receiving treatment services. 4. Overall Program Objectives Signal and WCDHS agree to monitor the ability of the substance abuse program offered by Signal to achieve objectives as follows: a. Demonstrate Abstinence with the use of UA monitoring only. b. Improve parental capabilities currently impaired by substance abuse. c. Develop the capacity to ask for help and assistance without resorting back to substance abuse. d. Develop or increase the ability to recognize, prioritize and meet child(ren)'s needs. Page 26 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS e. Parent will identify how their substance use has affected their parenting. f. Parent will identify how their substance use got them involved with Human Services. g. Parent will identify how their substance use helped them parent. h. Parent will identify relapse triggers and develop a safety plan for their children. i. Parent will identify whom they consider to be a support in their recovery. j. Parent will identify who will care for their children should they relapse. k. Parent will identify what they enjoy about parenting sober. I. Improve parent -child functioning to lower the risk of out of home placement. m. Parent will support their children in speaking about how living in a substance -effected family has impacted them. n. Parents will demonstrate increased verbal skills, empathy and accountability with child(ren). o. Parent will identify their parenting strengths. p. Family members, including significant other, children and extended family will increase ability to communicate more effectively. q. Family members will identify how they can support the identified client in their recovery. r. Family members will identify the positive parenting changes the substance -effected person is making. s. Family members will identify who will care for the children in the event of a relapse. t. Family members will identify relapse systems of the identified client. u. Family members will identify how they can reach out for help if a relapse occurs. v. Increase level of functioning currently impaired by living in a substance affected family. w. Identify how living in substance affected family has impacted their life. x. Improve level of functioning currently impaired by substance abuse issues. y. Decrease aggressive behaviors at home and/or school and in the community. z. Learn how to socialize without the use of substances. aa. Identify relapse triggers. bb. Create a sober support network. H. STAFF QUALIFICATIONS Signal staff members who will provide services to WCDHS clients will have credentials and/or certifications as required by the Colorado Department of Human Services, Page 27 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS Colorado Board of Education, Division of Behavioral Health, and the Colorado Board of Medical Examiners. 1. Intensive Outpatient Program Turning Point's Intensive Outpatient Program OOP) is designed to provide a high level of treatment intervention to support youth in their home and community. Trauma -informed care is provided in group, individual, and family/caregiver settings. The program includes treatment for substance use and mental health needs for youth 13-17 years of age. The youth/family referred will have opportunities to engage in: Individual therapy individualized to each youth's needs. This can be Trauma Focused Cognitive Behavioral Therapy, or they will be paired with an Addiction Specialist for substance use treatment. Group Therapy focusing on building skills, understanding symptoms, emotional intelligence, resiliency, relapse prevention, and other relevant TF-CBT or Addiction topics. Family Therapy to strengthen bonds, improve communication, and develop resiliency within the family and caregiver system Related case management services to link any necessary providers or services for parents and youth. Intake Assessment and bi-weekly treatment plan reviews. Ability to continue with the same therapist after successful completion of the Intensive Outpatient Program. Youth will receive 9 contact hours of service per week. This will include 1.5 hours of individual therapy, 1.5 hours of family therapy, and 6 hours of group therapy per week along with case management. The expected length of the program is approximately 6-12 weeks, however, can be adjusted to meet family, department, or team goals. The program goals are to: • Provide stability and support to youth and family/caregivers. • Provide a more intensive place for youth to learn and develop skills while remaining in the community. • Help youth decrease substance use. • Entry into Turning Point's continuum of care. • Strengthen family and caregiver relationships. Program outcomes include: Page 28 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS Decrease the need of out of home placements through stabilizing the youth's behaviors. • Improve family and caregiver stability. • Decrease substance use. • Healing from traumatic experiences. • Continuation of care within Turning Point. EXHIBIT D - ASSURANCES Page 29 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS 1. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, not shall any portion of this Agreement be deemed to have created a duty of care with respect to any persons not a party of this Agreement. 2. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year. 3. No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. 4. Signal assures that sufficient, auditable, and otherwise adequate records that will provide accurate, current, separate, and complete disclosure of the status of the funds received under the Contract are maintained for four (4) years or the until the completion and resolution of an audit, whichever is later. Such records shall be sufficient to allow authorized local, Federal, and State auditors, and representatives to audit and monitor Signal. 5. All such records, documents, communications, and other materials shall be the property of WCDHS and shall be maintained by Signal, in a central location and as custodian, on behalf of WCDHS, for a period of four (4) years from the date of final payment under this Contract, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four (4) year period, or if audit findings have not been resolved after a four (4) year period, the materials shall be retained until the resolution of the audit finding. 6. Signal assures that authorized local, federal, and state auditors and representatives shall, during business hours, have access to inspect any copy records, and shall be allowed to monitor and review through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 30 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS 7 Signal certifies that federal appropriated funds have not been paid or will be paid, by or on behalf of Signal, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, loan, grant, or cooperative agreement. 8. Signal assures that it will fully comply with all other applicable federal and state laws. Signal understands that the source of funds to be used under this Contract is: Colorado Core Services substance abuse treatment funds. 9. Signal assures and certifies that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a federal department of agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of, or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph 9(B) of this certification; and D. Have not within a three-year period preceding this Contract, had one or more public transactions (federal, state, and local) terminated for cause or default. 10. The Appearance of Conflict of Interest applies to the relationship of Signal with WCDHS when Signal also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for Signal to gain from knowledge of these opposing interests. It is only necessary that Signal know that the two relationships are in opposition. During the term of the Contract, Signal shall not enter any third -party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict -of -interest situation, Signal shall submit to WCDHS, a full disclosure statement setting forth the Page 31 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for WCDHS' termination, for cause, of its contract with Signal. 11. Signal shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected to the administration of Child Protection, no information about or obtained from any applicant/recipient in possession of Signal shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with Signal written policies governing access to, duplication and dissemination of, all such information. Signal shall advise its employees, agents, and sub -providers of Signal, if any, that they are subject to these confidentiality requirements. Signal shall provide its employees, agents, and sub -providers of Signal, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. 12. Proprietary information for the purposes of this contract is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by Signal in the course of providing services under this Contract will be accorded at least the same precautions as are employed by Signal for similar information in the course of its own business. 13. Signal certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors, and sub -contractors. Page 32 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS EXHIBIT E- STANDARDS OF PROCEDURES FOR CORE SERVICES 1. Signal and WCDHS agree to develop a case management plan (aka substance abuse treatment plan) on each referred family within 30 days of the date the Signal received the referral. The case management plan will be monitored and modified monthly to measure progress toward goals. Copies of the case management plan must be sent to the caseworker, program area supervisor, and Mental Health and Support Services Team at Weld County Department of Human Services, P. O. Box A, 822 7th Street, Suite 150, Greeley, Colorado 80632. The case management plan will include, at a minimum, goals, timelines, and measurement of success. 2. Signal agrees that payments for levels of care are not authorized for reimbursement by WCDHS until a referral from WCDHS is provided to Signal. A referral must be received prior to services rendered by Signal. Furthermore, Signal and its providers agree that any monitoring in conjunction with treatment beyond standard urinalysis and breathalyzer tests, as well as changes in level of care are not authorized for reimbursement by WCDHS until staffed with designated WCDHS staff. WCDHS agrees to identify designated staff that may provide this authorization. 3. Signal agrees not to accept any referral from WCDHS unless the referral contains all information required on the form and necessary for reimbursement by WCDHS and authorized for reimbursement. If Signal accepts the referral without all data fields required on the referral form or authorization, Signal may assume fiscal responsibility for the services provided under the incomplete referral. Inaccurate information listed on the referral form by WCDHS will be excluded as a fiscal responsibility for Signal. 4. Signal agrees to provide access to all monthly client progress reports for clients with treatment charges by the 7th day after the month of service, via the Signal website. The monthly progress report for each client must be entered into the Signal Service Management website by the provider previous to the monthly billing claims in order for payment to be honored. Failure to submit such monthly reports will result in delays or forfeiture of payment. It is expected, at a minimum, that these reports will reflect all information requested on the Monthly Progress Report. 5. Signal agrees to submit a final discharge summary of client outcomes to Human Services within thirty (30) calendar days after the completion date. 6. Signal agrees to report expenditures and case disbursement at agreed upon times. Page 33 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS 7. Signal agrees to assume fiscal responsibility for expenses incurred by Signal that do not meet the requirements of this Exhibit and Agreement. Those expenses incurred by Signal outside of the requirements of this Agreement are not eligible WCDHS expenditures and shall not be reimbursed by WCDHS. 8. Signal agrees to the definition of a complete and timely billing form for purposes of submitting an original bill under as described in this Exhibit. A complete and timely billing form must include the following elements. A. The billing must include all forms designed for Core Services reimbursement and approved by WCDHS; Core Services Authorization of Funds, Project Report, Update Report, and original signed client verification forms for therapy and group services. Additionally, Signal agrees to provide WCDHS monitoring results (UA, BA, patch, tox trap swab) by faxing said results to WCDHS at 970-346-7667 or via access to online system no later than 72 hours after the day of service. B. The Department will determine billed services not eligible for payment by identifying conflicts in the following: 1. Details provided in client referrals and renewals, including approved hours of service, begin and end dates of service, client name, and Case ID. 2. Details in supporting documentation provided by the Provider and submitted with the original bill, including, but not limited to, original signed client verifications, receipt of monitoring results, time of service and units or hours of service provided, and names of clients receiving the services, and monthly progress reports with all the information specified on the Monthly Progress Report. 3. Details provided in the current approved contract and Notification of Financial Assistance, including, but not limited to unit of service, cost per unit of service, and special conditions and/or revisions to said contract. C. The above items, 8 B,1, 2, and 3, will supersede all requests from Signal for review of billing errors. Items submitted for billing will be processed according to the criteria established by the above documentation. The Department will make obvious corrections to minor errors in the bill in order to expedite processing the claims for payment. Minor errors include missing or transposed digits in Household Numbers, TRAILS Case ID, or other Department -generated information. Page 34 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS D. An Administrative fee will be assessed to all fees reimbursed through County only funding. Such fees include, but are not limited to, those service fees previously billed and determined by the Department to be not eligible for payment. 9. Signal will develop and utilize evaluation tools (pre- and post -assessment test instruments) to collect necessary data in cooperation with WCDHS staff to monitor effectiveness of program. 10. Signal will meet with the WCDHS designated supervisor quarterly and/or a designated member of the Mental Health and Support Services Team (more if needed) to review program usage and effectiveness to discuss necessary improvements to better serve families or increase referrals. 11. Signal will be available to meet with WCDHS staff to explain program, timelines of response to referrals and answer questions to enhance program. 12. Signal, or their authorized designee, will be available for the Families, Youth and Children (FYC) Commission review and attendance at the FYC meetings. 13. Regarding all forms referenced herein in the Agreement, Signal shall replicate these forms in format, content and according to the specifications of WCDHS or as mutually agreed upon by Signal and WCDHS. Signal agrees to modify these treatment authorization forms according to WCDHS specifications and requirements. 14. WCDHS will be responsible for electronically authorizing services to various Signal providers and initially designating if Core funds shall be used for payment. WCDHS shall assure that the authorization will have all information required for reimbursement from the county. 15. WCDHS agrees to provide Signal with the name of a primary contact who will be responsible for interacting with Signal's data system. 16. WCDHS agrees to provide the TRAILS Remittance Advice to Signal within ten (10) business days of the monthly TRAILS Core Main Payroll date. 17. WCDHS agrees to render payment for one full billing invoice at a time, as billed monthly by Signal, and not to submit payment for a mixture of separate invoices within one payment. 18. Signal and WCDHS agree to resolve level of care conflicts at the Signal/County level through cooperation. WCDHS and Signal shall attempt to resolve all levels of care conflicts and disputes at the lowest level possible within each organization. Should Page 35 of 36 SIGNAL BEHAVIORAL HEALTH NETWORK WELD COUNTY DEPARTMENT OF HUMAN SERVICES SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2025 CHILD WELFARE CLIENTS WCDHS and/or Signal fail to agree upon the level of care offered by Signal, they may appeal the case directly to the WCDHS Director, or designee, and the Signal Chief Operating Officer. Both Signal and WCDHS will have an opportunity to provide consultation and documentation regarding the appeal. Appeals are to be resolved within 72 working hours, unless good cause justifies an extension. 19. If the WCDHS and Signal are unable to resolve the dispute, either party may request that the State intervene. Any further unresolved issues may be submitted to the Colorado Department of Human Services, Office of Behavioral Health or their designee(s) for case presentation and review. Page 36 of 36 SIGNATURE REQUESTED: Weld/Signal 2024-25 Agreement Final Audit Report 2024-06-04 Created: 2024-06-03 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAnNu_hGS6tm59Pp-If4PBMtzIwyf5yk4L "SIGNATURE REQUESTED: Weld/Signal 2024-25 Agreement" History t Document created by Windy Luna (wluna@weld.gov) 2024-06-03 - 11:24:58 PM GMT- IP address: 204.133.39.9 + Document emailed to DANIEL DARTING (ddarting@signalbhn.org) for signature 2024-06-03 - 11:29:15 PM GMT ,t Email viewed by DANIEL DARTING (ddarting@signalbhn.org) 2024-06-03 - 11:41:03 PM GMT- IP address: 104.47.70.126 6o Document e -signed by DANIEL DARTING (ddarting@signalbhn.org) Signature Date: 2024-06-03 - 11:41:28 PM GMT - Time Source: server- IP address: 71.237.3.222 L. Document emailed to julrich@weld.gov for signature 2024-06-03 - 11:41:29 PM GMT © Email sent to julrich@weld.gov bounced and could not be delivered 2024-06-03 - 11:47:10 PM GMT 4 Windy Luna (wluna@weld.gov) added alternate signer Jamie Ulrich (ulrichjj@weld.gov). The original signer julrich@weld.gov can still sign. 2024-06-03 - 11:48:06 PM GMT- IP address: 204.133.39.9 G-► Document emailed to Jamie Ulrich (ulrichjj@weld.gov) for signature 2024-06-03 - 11:48:07 PM GMT Po Email sent to julrich@weld.gov bounced and could not be delivered 2024-06-03 - 11:48:12 PM GMT- IP address: 204.133.39.9 Powered by Adobe Acrobat Sign 5 Email viewed by Jamie Ulrich (ulrichjj@weld.gov) 2024-06-04 - 5:03:28 PM GMT- IP address: 204.133.39.9 dSQ Document e -signed by Jamie Ulrich (ulrichjj@weld.gov) Signature Date: 2024-06-04 - 5:03:57 PM GMT - Time Source: server- IP address: 204.133.39.9 © Agreement completed. 2024-06-04 - 5:03:57 PM GMT Powered by Adobe Acrobat Sign ntract F Entity Information Entity Name * Entity ID* C) New Entity? SIGNAL BEHAVIORAL HEALTH @00033360 Contract Name * Contract ID Parent Contract ID SIGNAL BEHAVIORAL HEALTH AGREEMENT FY24-25 8303 Contract Status CTB REVIEW Contract Lead * WLUNA Contract Lead Email wluna@weldgov.com;cob bxxlk@weldgov.com Requires Board Approval YES Department Project # Contract Description SIGNAL BEHAVIORAL HEALTH SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT. CORE TERM: 06/01 /2024 THROUGH 05/31 /2025. NON -CORE TERM: 07/01 /24 THROUGH 06/30/2025. Contract Description 2 APPROVED PA ROUTING THROUGH ONBASE/CMS WITH THIS ENTRY. Contract Type * AGREEMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant IGA Department Requested BOCC Agenda Due Date HUMAN SERVICES Date* 06/15/2024 06/19/2024 Department Email CM- HumanServices@weldgov. com Department Head Email CM-HumanServices- DeptHead@weidgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL RN EY@WEL DGOV.COM Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Review Date 03/31/2025 Committed Delivery Date Renewal Date Expiration Date" 05/31/2025 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CHERYL PATTELLI BRUCE BARKER DH Approved Date Finance Approved Date Legal Counsel Approved Date 06/17/2024 06/18/2024 06/18/2024 Final Approval BOCC Approved Tyler Ref # AG 062624 BOCC Signed Date Originator WLUNA BOCC Agenda Date 06/26/2024 Hello